Uğuz Fatih Alper, Bozkuş Fulsen, Aksu Ekrem, Atilla Nurhan, Kahraman Hasan, Doğaner Adem
Department of Chest Diseases,Kahramanmaraş Sütçü İmam University, Faculty of Medicine, Kahramanmaraş, Turkey.
Department of Cardiology, Kahramanmaraş Sütçü İmam University, Faculty of Medicine, Kahramanmaraş, Turkey.
Turk Thorac J. 2022 Mar;23(2):97-103. doi: 10.5152/TurkThoracJ.2022.21075.
Altered cardiac repolarization is an important mechanism in the development of malignant cardiac arrhythmia and in the occurrence of sudden cardiac death. It is known that the risk of cardiac arrhythmia and sudden death is increased in patients with chronic obstructive pulmonary disease. Evaluating the measurements of repolarization in the electrocardiogram may provide useful information to determine potential risks for lethal arrhythmias in the patients with chronic obstructive pulmonary disease. In the present study, we investigated the possible relationships between repolarization parameters in the electrocardio and demographic, clinical, and biochemical findings in patients with chronic obstructive pulmonary disease.
In the present study, 35 patients with Global Initiative for Chronic Obstructive Lung Disease A-B constituted group 1 and 35 patients with Global Initiative for Chronic Obstructive Lung Disease C-D constituted group 2. Cardiac repolarization and dispersion (QTc interval and QT dispersion) were measured on 12-lead electrocardiogram. QTc interval, QT dispersion, TP-e, and Tp-e/ QTc were evaluated in order to determine the patients at risk of sudden cardiac death. QTc interval >440 ms in men and >460 ms in women was considered as prolonged QTc interval.
QTc and QTd values were found to be statistically significantly prolonged in the group of GOLD C-D compared to the group of GOLD A-B (P < .001). QTc value showed negative correlation with the ratio of forced expiratory volume in 1 second to forced vital capacity and partial pressure of oxygen (P = .030, r = -0.260; P = .006, r = -0.332, respectively). No significant difference was in Tp-e and Tp-e/QTc between the groups (P = .73, P = .12, respectively).
QTc and QTd are non-invasive markers reflecting arrhythmogenicity, and our findings were found to be related to prolonged QTc and QTd in patients with chronic obstructive pulmonary disease. Prolongation in the dispersion of repolarization and altered cardiac repolarization in the population with chronic obstructive pulmonary disease may be related to hypoxemia and airway obstruction. Alterations in the cardiac repolarization may put these patients at high risk for malignant ventricular arrhythmia and sudden cardiac death.
心脏复极改变是恶性心律失常发生及心源性猝死的重要机制。已知慢性阻塞性肺疾病患者发生心律失常和猝死的风险增加。评估心电图中的复极测量值可能为确定慢性阻塞性肺疾病患者发生致死性心律失常的潜在风险提供有用信息。在本研究中，我们调查了慢性阻塞性肺疾病患者心电图复极参数与人口统计学、临床及生化指标之间的可能关系。
在本研究中，35例全球慢性阻塞性肺疾病倡议组织（GOLD）分级为A - B级的患者构成第1组，35例GOLD分级为C - D级的患者构成第2组。在12导联心电图上测量心脏复极和离散度（QTc间期和QT离散度）。评估QTc间期、QT离散度、TP - e及Tp - e/QTc以确定有心脏性猝死风险的患者。男性QTc间期>440 ms且女性>460 ms被视为QTc间期延长。
与GOLD A - B组相比，GOLD C - D组的QTc和QTd值在统计学上显著延长（P <.001）。QTc值与1秒用力呼气容积与用力肺活量之比以及氧分压呈负相关（分别为P =.030，r = - 0.260；P =.006，r = - 0.332）。两组间Tp - e及Tp - e/QTc无显著差异（分别为P =.73，P =.
